Summer Art Camp Application Form

Medical Information
Does the camper have allergies including asthma?
Please explain on the field provided including any food the camper is allergic to
Is the camper currently under medication?
Please provide the details, the name of the medication and period of intake

Contact Information in Case of Emergency
Name

First NameLast Name
Contact Number
Relation to camper
Name

First NameLast Name
Contact Number
Relation to camper

Payment
Registration is $50. This is a nonrefundable fee. Your child is not enroll in camp until registration is paid.

Pay online at Patchprincess.com
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